Sepsis is a severe clinical condition wherein the body undergoes a systemic inflammatory response to a known or suspected infection. Sepsis causes serious illness which can lead to multiple organ failure and death.
Sepsis is typically triggered as a result of the body's aberrant physiologic response to a blood-borne infection. In particular, a cascade of immunological activity involving rapid activation of neutrophils and macrophages, up-regulation of lymphocyte co-stimulatory molecules and rapid lymphocyte apoptosis, contributes significantly to the pathogenesis of this condition. The systemic release of cytokines, such as TNF-α, also causes dysregulation of the coagulation system and associated collapse of blood vessels. At the same time, disseminated activation of immunological pathways, such as the complement cascade, leads to wide-spread tissue and organ damage. A specific example of end-organ dysfunction is acute respiratory distress syndrome (ARDS). ARDS is characterized by inflammation of the lung parenchyma leading to impaired gas exchange with concomitant systemic release of inflammatory mediators causing inflammation, hypoxemia and frequently resulting in multiple organ failure.
The incidence of sepsis continues to increase worldwide, yet the mortality rate for this condition remains relatively high at between 20-40%. Improved knowledge of this complex condition is facilitating the development of new strategies for treatment; however, improved treatment options are still in high demand.
Apheresis is a treatment used for depletion of blood components, such as antibodies, low-density lipoproteins (LDL) and blood cells. Leukapheresis is the apheresis treatment used for removal of white blood cells, leukocytes. The patient is connected to an extracorporeal blood circulating system; the blood is drawn from a vein in one arm, passed through a column device and returned into the other arm of the patient. WO2010/029317 describes apheresis columns useful for treating inflammatory conditions including a chemokine immobilised on a solid support.